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Bone deposition/generation with LeFort III (midface) distraction.

John N Jensen¹, Joseph G McCarthy, Barry H Grayson

¹Milwaukee, Wis.; New York, N.Y.; and Ankara Turkey From the Department of Plastic Surgery, Medical College of Wisconsin; Institute of Reconstructive Plastic Surgery, New York University School of Medicine; and Department of Radiology, New York University School of Medicine.

Plastic and Reconstructive Surgery

|January 27, 2007

Summary

Bone deposition after midface distraction surgery (LeFort III osteotomy) is most consistent in the medial facial skeleton. Osteotomy through the zygomatic body yields better bone bridging than through the arch.

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Area of Science:

Craniofacial surgery
Orthognathic surgery
Bone regeneration

Background:

Assessing bone deposition is crucial for midface distraction procedures.
Midface distraction aims to correct skeletal discrepancies.
Understanding bone healing at osteotomy sites is key for surgical outcomes.

Purpose of the Study:

To characterize bone deposition quality and volume.
To evaluate specific osteotomy sites after midface distraction.
To analyze bone bridging in syndromic craniosynostosis patients.

Main Methods:

Computed tomographic (CT) scans with 3D reconstruction were used.
10 patients with syndromic craniosynostosis underwent LeFort III osteotomy and distraction.
Blinded observers evaluated bone deposition at predetermined sites.

Main Results:

Variable bone bridging occurred at all osteotomy sites.
Bone deposition was most reliable at the pterygomaxillary buttress and nasofrontal junction.
Medial orbital walls showed more consistent deposition than lateral walls; zygomatic arch deposition was least likely.

Conclusions:

Bone deposition is more reliable in the medial facial skeleton post-LeFort III osteotomy.
Osteotomy through the zygomatic body promotes more deposition than through the arch.
Findings guide surgical planning for optimal bone regeneration.